title: Buprenorphine/naloxone therapy for opioid refractory neuropathic pain following traumatic amputation: a case series.
abstract: Phantom limb pain is a common consequence of limb amputation and is prevalent among the service members sustaining traumatic battlefield limb injuries during the conflicts in Iraq and Afghanistan. Current treatment to relieve phantom limb pain consists of physical, behavioral, and medical modalities including opioids and adjunct medications. Treatment failure resulting in persistent pain and disability may result. This case series describes four previously healthy service members who developed phantom limb pain following traumatic amputation successfully treated with buprenorphine/naloxone after failing traditional treatment. This is the first reported case series of patients expressing improved pain control with decreased frequency of phantom limb pain with the use of buprenorphine/naloxone instead of traditional opioid agonists.
authors.affiliation: Department of Anesthesiology, Georgetown University School of Medicine, 4000 Reservoir Road NW, Washington, DC 20007, USA.
authors.forename: Lauren
authors.initials: L
authors.lastname: Licina
authors.forename: Carlyle
authors.initials: C
authors.lastname: Hamsher
authors.forename: Karl
authors.initials: K
authors.lastname: Lautenschager
authors.forename: Sandeep
authors.initials: S
authors.lastname: Dhanjal
authors.forename: Necia
authors.initials: N
authors.lastname: Williams
authors.forename: Christopher
authors.initials: C
authors.lastname: Spevak
mesh_terms: D000328:Adult; D000673:Amputation, Traumatic / Q000150:complications; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D002047:Buprenorphine / Q000627:therapeutic use*; D000069479:Buprenorphine, Naloxone Drug Combination; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D009270:Naloxone / Q000627:therapeutic use*; D009437:Neuralgia / Q000188:drug therapy* / Q000209:etiology; D010591:Phantom Limb / Q000188:drug therapy* / Q000209:etiology; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D000069479:Buprenorphine, Naloxone Drug Combination; D009270:Naloxone; D002047:Buprenorphine